Assist with planning, directing, and implementing managed care objectives related to contract terms, reimbursement, negotiation, and key payer relationship management.
Negotiate various contract types across the organization's geographies and business lines with significant payer relationships.
Secure favorable reimbursement, protect the interests of associated entities in contract negotiations, and strengthen relationships with significant payers.
CommonSpirit Health is building a healthier future for all through its integrated health services. As one of the nation’s largest nonprofit Catholic healthcare organizations, CommonSpirit Health delivers more than 20 million patient encounters annually through more than 2,300 clinics, care sites and 137 hospital-based locations, in addition to its home-based services and virtual care offerings.
Initiate, negotiate, and execute contracts with physicians and healthcare providers.
Analyze financial impacts and maintain documentation within a tracking system.
Advise leadership on functional strategies regarding provider contracts.
Jobgether uses an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates and share this shortlist directly with the hiring company.
Review payer financial reconciliations for accuracy and adherence to agreed-upon methodologies.
Support for the development and deployment of audit procedures applied to payer data sets.
Partner across teams and with payers to resolve data discrepancies.
Aledade empowers independent primary care practices to deliver better care to their patients and thrive in value-based care. They are the largest network of independent primary care in the country with a collaborative, inclusive, and remote-first culture.
Serve as primary relationship lead for assigned health plan partners
Own internal revenue and performance targets tied to your payer markets
Analyze operational and program data to identify risks and growth opportunities
Mae is a venture-backed digital health solution on a mission to improve the health and quality of life for mothers, babies, and those who love them. Mae has created a space where complete digital care meets culturally-competent on-the-ground support.
Develop and execute comprehensive territory or domain plans.
Build strong relationships with C-suite and executive-level stakeholders.
Lead all aspects of the sales cycle, from qualification to closing.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly. They appreciate candidates' interest and wish them the best.
Develop and execute strategies to improve client retention, engagement, and expansion.
Analyze client data to identify trends and actionable insights.
Build strong relationships with client stakeholders and address their concerns.
They use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Lead health plan partnerships across Medicaid and related lines of business.
Serve as the senior relationship owner for a portfolio of managed care health plan partners.
Identify performance risks early and lead cross-functional action plans to improve outcomes.
Zócalo Health is a tech-enabled, community-oriented primary care organization serving people who have historically been underserved by the healthcare system. Founded in 2021, the company is backed by leading healthcare and mission-aligned investors and is scaling rapidly across states and populations.
Serve as the subject matter expert in interpreting payer agreements.
Collaborate with the Provider Network Operations team to support the build of standard operating procedures.
Maintain reconciliation trackers to measure contract performance and support audit requests.
Aledade empowers independent primary care practices to deliver better care and thrive in value-based care. They are the largest network of independent primary care in the country, creating value-based contracts across various health plans.
Analyzes new and revised hospital contracts, determines necessary actions, documents requirements, and establishes customer accounts.
Effectively communicates with external and internal customers throughout the contract process to ensure timely information reception.
Identifies opportunities and initiates process improvements, including written documentation in a process manual.
Pediatrix Medical Group is a physician-led organization and one of the nation’s largest providers of prenatal, neonatal, and pediatric services. They are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.
Serve as senior escalation point for client performance.
Lead Quarterly Business Reviews (QBRs).
Ternium RCM specializes in resolving complex healthcare insurance claim denials and delays. They empower hospitals and health systems by optimizing their revenue cycle, allowing them to focus on patient care. The company delivers outstanding results and enhances the patient experience.
The Hospital Contract Definition Analyst plays a critical role in the implementation and maintenance of hospital payer contracts within Experian Health's Contract Manager system.
You will ensure accurate modeling of reimbursement methodologies to support valuation of hospital claims and patient estimates and collaborate with senior team members to process new client implementations.
Independently manages routine maintenance cases, ensuring compliance with enterprise standards and client expectations.
Experian is a global data and technology company, powering opportunities for people and businesses around the world. A FTSE 100 Index company listed on the London Stock Exchange (EXPN), they have a team of 23,300 people across 32 countries where their corporate headquarters are in Dublin, Ireland.
Independently own aligning operations for client accounts.
Translate performance data into narratives that clearly articulate drivers, risks, and opportunities.
Partner with clients to align operational expectations with internal capabilities.
EnableComp provides Specialty Revenue Cycle Management solutions for healthcare organizations, leveraging over 24 years of industry-leading expertise and its unified E360 RCM ™ intelligent automation platform to improve financial sustainability. It is a multi-year recipient the Top Workplaces award and was recognized as Black Book's #1 Specialty Revenue Cycle Management Solution provider in 2024 and is among the top one percent of companies to make the Inc. 5000 list.
Support Rula’s Revenue Cycle and payer expansion initiatives.
Own post-launch performance monitoring and optimization.
Diagnose issues, improve workflows, and build scalable systems.
Rula is dedicated to treating the whole person and aims to create a world where mental health is no longer stigmatized or marginalized. They are passionate about making a positive impact on the lives of those struggling with mental health issues.
Manage a significant region of the US and generate payor leads.
Build and maintain relationships with key decision-makers in payors.
Develop strategic account plans that identify growth opportunities.
Evermore is a technology company that administers Smart Benefits to connect people to products and services they need, when they need them, so they can live healthier lives. Evermore is a Series B stage company, backed by leading investors.
Manage fee schedule development, updates, and maintenance.
Maven is the world's largest virtual clinic for women and families on a mission to make healthcare work for all of us. They have raised more than $425 million in funding from top healthcare and technology investors and have an award-winning culture working towards an important mission.
Develops value proposition resources and key messages aligned with Brand strategy.
Supports Payer Accounts team in strategic and tactical business planning for payers and hospitals.
Iovance is dedicated to developing and delivering novel cancer immunotherapies. They are an equal-opportunity employer committed to cultivating a diverse and inclusive work environment.
Prospect and build relationships with health systems, hospitals, and public sector healthcare entities.
Identify and engage key decision-makers including CFOs and CEOs.
Drive the full sales cycle from outreach to contract negotiation.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. Their system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Ensure excellence in revenue cycle solution delivery across all new and existing customer deployments.
Recruit, mentor, and lead a high-performing team of client-facing revenue cycle solution consultants.
Partner with Implementation, Product, and Engineering teams to align complex solutions with product strategy and client timelines.
SmarterDx, a Smarter Technologies company, builds clinical AI that is transforming how hospitals translate care into payment. Founded by physicians in 2020, their platform connects clinical context with revenue intelligence, helping health systems recover millions in missed revenue, improve quality scores, and appeal every denial.